A technique for continuous infusion into the mouse bladder

A new technique is described for long term placement of an indwelling catheter into the mouse bladder. This technique allows the animal to void normally while receiving an intravesical infusion for several weeks. The presence of the catheter still enables MBT-2 tumor cells to implant into the bladder wall. This model will be useful for investigating the effect of various anticancer agents administered intravesically over prolonged periods of time.

Diagnosis of renal parenchymal diseases by a modified open kidney biopsy technique

A modified open renal biopsy technique was performed under local anesthesia on 129 patients over a 10-year period. This technique yielded sufficient tissue to establish a diagnosis for every patient. The mean number of glomeruli obtained was 54 +/- 3; the mean duration of the operation was 71 +/- 2 min. No deaths resulted and only one major complication developed following this procedure which required additional surgery. Two patients required blood transfusions following surgery and both had a bleeding abnormality. These results demonstrate that the modified open renal biopsy technique is a safe and reliable procedure that should be performed whenever the percutaneous route is either unsuccessful or contraindicated.

Simultaneous occurrence of transitional, squamous and adenocarcinoma of the bladder after 15 years of cyclophosphamide ingestion

We report on a patient who had a urothelial tumor with tri-differentiation into transitional squamous and adenocarcinoma after ingestion of 285 gm. cyclophosphamide during a 15-year-period. The possibility is again raised that the use of high doses of this drug over long periods may be associated with an increased incidence of carcinoma of the bladder. Frequent cystoscopic examinations may be warranted in patients who have received large cumulative amounts of the drug

Angiogenic activity as a marker of neoplastic and preneoplastic lesions of the human bladder

Angiogenic activity has been assessed in biopsy specimens from 49 patients with transitional cell carcinoma, benign prostatic hypertrophy and vesicoureteral reflux. Over 95% of the specimens containing malignant and premalignant transitional epithelium stimulated capillary proliferation on rabbit iris. In contrast, less than 10% of normal tissues had this effect. Sixty-one per cent of specimens with inflammatory round cells were angiogenic but this was reduced to 10% by preincubation with rabbit antihuman lymphocyte serum. Cystitis cystica also induced capillary proliferation even if incubated with the antilymphocyte serum. Angiogenic capacity may be an early marker of preneoplastic and neoplastic lesions of the human bladder.

Wound infections and systemic antibiotic prophylaxis in gynecologic surgery. A review

The gynecologic literature was reviewed and yielded 11 well-designed and well-conducted studies since 1960 involving the use of systemic prophylactic antibiotics. Five had significant results that support using prophylactic antibiotics in vaginal hysterectomy while three supported prophylaxis in cesarean sections. A cephalosporin agent is effective as a prophylactic agent and should be administered 2 hours before surgery by the intravenous route and discontinued 24-72 hours after surgery. A change in the bacteriologic flora of the cervical cuff occurs after surgery with an increase in E. coli and enterococci and a decrease in coagulose negative staphylococci and steptococci. Future studies should be randomized, prospective, and performed in a double-blind manner with antibiotics begun preoperatively. Special attention should be given to bacteriologic techniques, especially the search for anaerobic pathogens.

Use of systemic antibiotics for prophylaxis in surgery: a critical review

We reviewed the English-language literature over a 16-year period (1960 through 1976) on the subject of prophylaxis with systemic antibiotics in surgery. Trials in genitourinary and cardiovascular surgery were not reviewed. Our definition of prophylaxis is antibiotic administration of the absence of infection or contamination. Of 131 articles reporting clinical trials using systemic antibiotics for prophylaxis, only 24 met the criterion on an appropriately designed study that generated evaluable data. In these, systemic antibiotics were shown to be of value in reducing wound infections after abdominal and vaginal hysterectomy, cesarean section, biliary surgery, total hip replacement, and microneurosurgical craniotomy. Antibiotic prophylaxis was of no value in laparotomy and groin hernia repair. Patients undergoing any of 21 different operations did not benefit from prophylactic antibiotic administration, though study groups were too small or infection rates too low to allow for firm conclusions. In certain patients at high risk of infection, systemic prophylaxis is warranted. Future clinical studies must be designed as randomized, blinded, prospective trials, with antibiotics administered by a parenteral route beginning preoperatively.